Hemorrhoids are lumps or masses of tissue in the anus, which contain enlarged blood vessels. Any increase in abdominal pressure may produce hemorrhoids. Repeated straining to have a bowel movement, especially in people who suffer from frequent constipation. Many patients have no apparent explanation for the formation of hemorrhoids, however. Internal hemorrhoids lie inside the anal canal, where they primarily cause the symptom of intermittent bleeding, usually with bowel movements, and sometimes mucous discharge. Usually the prolapsed hemorrhoid can be pushed back into the anus with a finger tip.
These lie just outside the anal opening, where they primarily cause symptoms of swelling or bothersome protrusions, and sometimes discomfort. Swelling and discomfort may occur only intermittently. External hemorrhoids may also cause difficulties keeping the anal area clean after bowel movements. Many patients have both internal and external hemorrhoids. Hemorrhoids are a very common health problem.
Hemorrhoids are more likely to develop in individuals who eat insufficient dietary fiber and don’t get enough exercise, which can lead to repeated episodes of constipation and straining to have bowel movements. Bright red blood on the toilet paper after having a bowel movement, especially if the stool was very hard or very large. Blood also may streak the surface of the stool, or color the water in the toilet bowl. For a prolapsed hemorrhoid, a soft, grape-like mass protruding from the anus that may discharge mucous.
For external hemorrhoids, bothersome protrusions and difficulties keeping the anal area clean. External hemorrhoids may also cause intermittent swelling, irritation, and mild discomfort, especially after a period of diarrhea or constipation. For thrombosis of an external hemorrhoid, a painful bulge or firm lump suddenly appears at the rim of the anus. The lump may have a blue or purple tint. If there is rectal bleeding, it is important that a physician also checks for other more dangerous causes of bleeding, such as colorectal cancer. In pregnant women, hemorrhoid symptoms usually improve dramatically or disappear after childbirth. Intermittent slight bleeding from hemorrhoids may carry on for months or years.
Painful swelling from thrombosis of an external hemorrhoid usually resolves over a period of days to weeks. Prevention You can often prevent hemorrhoids by preventing constipation. Add more fiber to your diet. Set a goal of 25 to 30 grams of fiber daily, from such high fiber foods as beans, broccoli, carrots, bran, whole grains and fresh fruits. To avoid bloating and gas, add fiber to your diet gradually over a period of several days. For most healthy adults, this is the equivalent of 6 to 8 glasses of water daily. Begin a program of regular exercise. As little as 20 minutes of brisk walking daily can stimulate your bowel to move regularly. Train your digestive tract to have regular bowel movements.
Schedule a time to sit on the toilet at approximately the same time each day. The best time to do this is usually right after a meal. Respond immediately to the urge to have a bowel movement. Do not postpone until the time is more convenient. Take a fiber powder to soften the stool. Sit in a tub or pan of plain warm water, 3 or 4 times a day, for 15-20 minutes each time. The water will keep the area clean, and the warmth will reduce inflammation and discomfort.
Be certain to dry the rectal area thoroughly after each sitz bath. Apply a cold compress or icepack to the anal area, or try a cool cotton pad soaked in witch hazel. Apply petroleum jelly or aloe vera gel to the anal area, or use an over-the-counter hemorrhoid preparation containing lidocaine or hydrocortisone. After every bowel movement, clean the anal area with a witch hazel pad, a soothing baby wipe or a cotton cloth soaked in warm water. Aggressive rubbing and scrubbing, especially with soaps or other skin cleansers, can irritate the skin and make your hemorrhoids worse. A rubber band is slipped around the base of an internal hemorrhoid to cut off its circulation.
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